Success Stories—‘A Low GI Diet – Best Thing I've Done in a Long Time’ Says Lorraine—Jaws Drop at the Gym When Margaret Walks In

What's New?—Weight Loss for Food Lovers

Feedback—Your FAQs Answered

What’s the GI of meat, chicken, fish, eggs and cheese? I can’t find these foods in the GI database.

I have heard that pasta made of strong wheat flour (such as durum) has a lower GI than pasta made of softer wheat flour. Is this true?

I've been following The Low GI Diet and have noticed some recipes include the use of filo pastry. Does filo pastry have a low GI? I love spinach pastries and even vegetable pies, but I am wondering if pastries have a high GI value?

I have read in some GI lists that fresh coconut is low GI, is this true? Coconut does not seem to be on your list!

Look it up in our A–Z: The GI Glossary continued

Events—Carbohydrates, Glycemic Index and Health: The State of the Art—Dietary Study for Women with PCOS

Welcome to our first anniversary issue. We would like to thank the thousands of subscribers and visitors who have made the newsletter such a success and whose comments and questions have played a key role in shaping the newsletter over the first twelve months.

The GI Group launched GI News a year ago to make available to a broader audience the latest scientific research covering carbohydrates and health (including both positive and negative GI research results), diet and weight loss; diabetes; heart disease; and PCOS along with the latest published GI values. To help people incorporate more of the right carbs into their own diet and lifestyle, we also included information on low GI foods and a recipe or two. And to inspire and motivate we added blood glucose control ‘success stories’. We wanted to hear what our visitors had to say, too. That’s why we set GI News up as a blogspot to allow people to post their own comments or send questions to the GI Group for more detailed answers.

Since posting our first issue on 11 July 2005, we have clocked up around 250,000 visitors and have more than 16,000 subscribers from right around the world. We are pretty proud of this result as we don’t have any sponsorship or advertising dollars to spend on promotion. To receive our free e-newsletter each month, all you have to do is click the SUBSCRIBE link in the right-hand column. Your email address will be kept strictly confidential and you can unsubscribe at any time. We hope you enjoy our first anniversary issue and please pass the link on to friends and colleagues you feel will find the site useful.GI News Editor: Philippa SandallWeb Design and Management: Scott Dickinson

Slow Carb Not Low CarbIn May, ‘News Brief’ reported on a woman who was hospitalised for life-threatening ketoacidosis after following the Atkins diet. We then listed the reasons why we advocated a low GI diet rather than a low carbohydrate diet. Some of our readers admonished us for our stance. Here are their comments and our responses.

Opposers of low carb regimes tend to stick to criticism that are really directed to the so called ‘induction phase’ which lasts only two weeks. After that, dieters on Atkins can and should consume a great variety of green, leafy nutritious vegetables, among many others, like mushrooms, eggplant, peppers, broccoli, cauliflower etc. Atkins never encourages you to eat zero carbs. 20 grams for the first 2 weeks, and you raise those levels after that.Yes, that’s true, criticism is often aimed at the induction phase but it’s also true that the second phase is restricted in carbohydrates (around 50 grams a day) too, and adherents are encouraged to return to the induction phase (20 grams a day) if weight loss slows. Furthermore, because Atkins recognised that the diet was not nutritionally balanced, a vitamin and mineral supplement program is compulsory.

The study by Yancy et al (Annals of Internal Medicine 2004: 140; 769) compared an Atkins diet with a prudent (low fat but high GI) diet in 120 overweight volunteers. Those following the Atkins diet lost twice as much weight in 24 weeks but read the small print. Specifically, adverse effects occurred more frequently in the low-carbohydrate diet group than in the low-fat diet group, including constipation (68% vs. 35%; P < p =" 0.03)," p =" 0.02)," p =" 0.01)," p =" 0.006)." style="font-style: italic;">Annals of Internal Medicine 2004; 140: 778), two persons on the low carbohydrate diet died, and a third was hospitalised. No such adverse events were recorded in those following the high carbohydrate diet.

There might have been some underlying health reasons for the ketoacidosis you mention.The case of a woman who was hospitalised for life-threatening ketoacidosis was written up in The Lancet (Chen TY, Smith W, Rosenstock JL, Lessnau KD The Lancet – Vol. 367, Issue 9514, 18 March 2006, Page 958). The precipitating factor, whatever her individual vulnerability, was strict adherence to a low carbohydrate diet. Fortunately, most people don’t or can’t adhere strictly to the Atkins diet.

No diet is really recommended for ill or pregnant people.Pregnant women have to eat and the diet they eat affects their baby’s development. We use the word ‘diet’ in the sense of ‘eating plan’ (as defined by most dictionaries), not restricted energy intake. We agree that it’s not a good idea to restrict energy intake during pregnancy (one reason being the adverse effect of ketones on fetal development). But it’s vitally important that women eat a healthy diet throughout their pregnancy and throughout their reproductive years – because not every pregnancy is planned. A low GI diet fits the bill perfectly, a low carbohydrate diet doesn’t (and you appear to agree). If a diet’s not good for a developing fetus, why would it be good for anyone else?

It is not true that consuming bad fats is unavoidable. You can and should avoid them and stay within Atkins.If carbohydrates occupy only 10% of your energy intake (i.e. you eat about 50 grams of carbohydrates per day), then the other 90% of energy must come from a mix of protein and fat. The upper limit on protein intake by humans is around 40% of their calories (kilojoules) because of limits on the liver’s capacity to produce urea. By a process of deduction, that means more than 50% (and more often 60%) of energy comes from fat. Even if you ate a perfectly healthy balanced diet with a P:M:S: ratio of 1:1:1 (polyunsaturated, monounsaturated, saturated fat), you’d be consuming about 20% of your calories as saturated fat. The recommendation is less than 10%.

I love carbs, I could be happy with a GI diet, and I will resort to it as soon as I reach my goal weight, but losing weight with GI diets is complicated because as soon as you surpass the level of carbs you can consume, you stop losing weight and start gaining.That was the claim Atkins made but he had no scientific evidence to back that. To our knowledge, there’s still no evidence. Indeed, recent studies suggest that people find it very hard to stick to a diet with so little carbohydrate (too much discipline is needed) and eventually re-gain the weight they lost. Is there any point in losing weight and then re-gaining it? Wouldn’t it be better to align food habits with something that’s not only healthy, helps you lose weight and keep it off for good?

As soon as I can start incorporating more carbs into my diet, they will be of the low glycemic load kind.That’s good. Why not cut to the chase early?

There should really be no quarrel between low glycemic and Atkins because they are fundamentally the same. The diets you should be strongly opposing are the low caloric and the low fat diets.No, that’s incorrect. Atkins wants to ditch carbs. Low GI diets can be moderately or even very high in carbs, but of the low GI kind. If Atkins had known what we know now, he would have seen ways to lower insulin levels without cutting the carbs. He recognised that high insulin levels interfered with weight control, but he did not have sufficient knowledge to work out the best way to lower insulin. Remember he had no training in nutrition.

The truth is that Atkins works. Once you get to your equilibrium level, then you can do low GL and stay in a narrow weight band.Yes, we agree that Atkins works in the short term. But not the long term. So what’s the point in following such a diet?

James Krieger, M.S., M.S. 20/20 Lifestyles Research Associate, PRO Club (http://www.proclub.com) and Editor, Journal of Pure Power (http://www.jopp.us) makes the point that: ‘You lose fat, water, and muscle’ is true of ANY diet. My recent meta-regression, published in the February 2006 issue of AJCN, shows quite clearly that fat loss is significantly higher on ketogenic diets, even after control for energy intake. Fat-free mass loss was also greater, but not by a large amount.

James Krieger

‘There is no apparent metabolic advantage associated with ketosis during dieting’ report researchers from the Department of Nutrition, Arizona State University, Inflammation Research Foundation, Marblehead and Conscious Cuisine, Scottsdale in the May issue of the American Journal of Clinical Nutrition. In summarising their findings, Prof. Carol Johnson says: ‘In the current study, the ketogenic low-carb diet did not offer any significant metabolic advantage over the nonketogenic low-carb diet. Both diets were effective at reducing total body mass and insulin resistance, but, because blood ketones were directly related to LDL-cholesterol concentrations and because inflammatory risk was elevated with adherence to the ketogenic diet, severe restrictions in dietary carbohydrate are not warranted. Furthermore, the nonketogenic low-carb diet was associated with feelings of high energy and a more favorable mood profile than was the ketogenic low-carb diet.’ They recommend anyone wanting to follow a low-carb diet to choose low-fat meats and dairy products, and eat 8–9 servings of fruit and vegetables and 100–125 grams of carbohydrate a day.

Unite for DiabetesDuring the last 20 years, the total number of people worldwide with diabetes has risen from 30 million to 230 million according to the International Diabetes Federation. The number is expected to reach 350 million by 2025. The top five countries with the most diabetes sufferers in 2003 were India 35.5 million, China 23.8 million, USA 16 million, Russia 9.7 million and Japan 6.7 million.

Facing the facts:

There are 6 million new diabetes sufferers in the world each year.

Half of all diabetes sufferers around the globe do not know they have it. In some parts of the world 80% of sufferers don't know.

Diabetes raises the sufferer's risk of developing a cardiovascular disease by two to four times. Cardiovascular disease, the number one cause of death in the industrial world, will soon be the number one cause of death globally.

Diabetes is now the fourth biggest cause of death worldwide.

Every ten seconds someone in the world dies as a result of having diabetes – 3 million deaths a year.

Good control of blood glucose levels significantly reduces the diabetes patients’ risk of developing complications. Managing hypertension and raised blood lipids is also crucial.

Diabetes is threatening to overwhelm future medical services if left unchecked. The International Diabetes Federation (IDF) is leading a worldwide ‘Unite for Diabetes’ campaign to have the United Nations recognise the global burden of diabetes. Why a UN resolution? If governments begin now by promoting low-cost strategies to alter diet, increase physical activity and modify lifestyles, the advance can be reversed. The proposed resolution would recognise the need for prevention and acknowledge the special needs of children and adolescents, the elderly, pregnant women, migrant populations and indigenous peoples. The aim is for the UN Resolution to be declared on World Diabetes Day 2007 (November 14). For more information about the campaign, visit www.unitefordiabetes.org.– International Diabetes Federation Press Release from the American Diabetes Association’s 66th Scientific Sessions

The Rice FactorHeart disease and diabetes are serious health problems in Japan just as they are in many other parts of the world. In fact, heart disease is the second leading cause of all deaths and more than 6.7 million people in Japan have diabetes. Will adopting a low GI or low GL diet reduce the risk? So far, most studies showing the beneficial effects of low GI and GL diets have been carried out in the US, Europe and Australia with people who eat western diets. What happens in Asia where rice is the staple? In Japan, for example, rice contributes 43% to total carb intake and 29% to energy intake (calories).

Japanese researchers have found positive correlations between dietary GI and body mass index, serum triglyceride levels, fasting plasma glucose and HbA1c; and between GL and serum triglyceride levels, fasting plasma glucose and decreased levels of high-density lipoprotein (HDL), or good, cholesterol. They published the results of their cross-sectional study of 1354 healthy Japanese women eating a traditional diet based on a self-administered diet-history questionnaire in AJCN (May 2006). The main contributor to the GI and GL of the women’s diet was white rice (59%) followed by confectionary (11%), fruit (7%), sugars (6%), bread (4%), noodles (3%), other rice (3%), and potatoes (3%). The authors make the point that although the results may not be extrapolated into the general Japanese population (the subjects were selected Japanese female farmers), they should ‘provide valuable insight from a prevention perspective.’– Am J Clin Nutr 2006;83: 11161–9

Fortelling Early Insulin Resistance‘Insulin resistance not only predisposes individuals to type 2 diabetes, it is also a major risk factor for cardiovascular disease,’ says Timothy Graham, MD, a researcher at Beth Israel Deaconess Medical Center (BIDMC). ‘In the clinical setting however, it is often difficult to distinguish individuals with and without insulin resistance.’ Insulin resistance develops when the body's muscles, fat and liver cells lose the ability to respond to the hormone insulin.

Elevated levels of a molecule called retinol-binding-protein-4 (RBP4) can foretell early stages of insulin resistance, a major cause of type 2 diabetes as well as heart disease, reveal BIDMC researchers writing in The New England Journal of Medicine.

The researchers were looking to see whether levels of RBP4 correlated with the presence or absence of insulin resistance in three groups and they repeated the measurements after exercise training for one group. They found that RBP4 levels were higher in all cases in which insulin resistance was high. Elevated RBP4 was also closely associated with increased BMI, waist-to-hip ratio, serum triglyceride levels, and systolic blood pressure, as well as decreased levels of high-density lipoprotein (HDL), or good, cholesterol. All the people who improved their insulin sensitivity with exercise also lowered their serum RBP4 levels. Among the third who did not improve their insulin sensitivity, neither did their RBP4 levels go down.

Dr Barbara Kahn

Barbara Kahn, MD, Chief of the Division of Diabetes, Endocrinology and Metabolism at BIDMC and Professor of Medicine at Harvard Medical School says: ‘Collectively, these findings tell us that RBP4 is a useful marker for therapeutic improvement and that this protein could play a causal role in insulin resistance in humans. Because RBP4 levels consistently corresponded with insulin resistance – even among lean subjects whose genetic risk for the development of diabetes might otherwise be overlooked – this protein could be an important marker for type 2 diabetes among the general population. Being able to determine diabetes risk well before the onset of symptoms could provide an important opportunity for patients to take preventive measures,’ she adds. ‘For those who are overweight or sedentary, this could mean making changes to their diet and fitness routines. For those who are lean and fit, but have a family history of type 2 diabetes, this could mean taking antidiabetic medication. Either way, these findings could help clinicians to better manage this growing epidemic.’– NEJM 354:2552–2563; BIDMC Press Release

GI: The Real Meal DealRecent criticism of the GI has focused on unpredictable outcomes of blood glucose values in meals because of variations in fat, protein and fibre levels.

Researchers in the University of Toronto's Department of Nutritional Sciences and the University of Sydney’s Human Nutrition Unit have some reassurance for people with diabetes and carb-counters. The glycemic index (GI), the table that lists the quality of carbohydrates in more than 750 common foods, works just as predictably whether subjects consume a single portion of one item, or a normal meal. ‘The good news it that the GI index works’ says Prof. Tom Wolever. ‘For sensible people it makes a lot of sense. It's simple proportional measure – like mixing paint.’

Concerned about the methodology of recent studies done elsewhere showing unpredictable responses, Wolver and his associate, Prof. Jennie Brand-Miller of the University of Sydney, each conducted studies on two groups of healthy subjects. Fourteen different test meals were used in Sydney and Toronto, and the food combinations reflected typical breakfast choices such as juice, bagels and cream cheese, etc. Despite the variations in food, blood glucose responses remained consistent with GI measures.

‘We had previously done much smaller studies. We revisited the question, using more meals and variety in two different centres with judiciously selected foods. I was startled by the degree of predictability,’ says Wolever. ‘The carbohydrate, fat and protein composition of the meals varied over a wide spectrum. The glucose responses varied over a five-fold range range, and 90 per cent of the variation was explained by the amount of carbohydrate in the meal and the GI values of the foods as given in published GI tables. The concept works.’ The results are published in the June issue of the American Journal of Clinical Nutrition.– Am J Clin Nutr 2006;83:1306–12; University of Toronto press release

BeveragesRibena blackcurrant fruit syrup (prepared with water according to the instructions) GI 52Schweppes lemonade GI 54

In publishing the GI values of two sweetened drinks, Kaye Foster-Powell reminds parents that they are definitely not an everyday beverage. Here’s why.

‘Liquid calories are a little stealthier than most, in that they tend to sneak past the satiety centre in our brain, which would normally help to stop us from overeating,’ she says. ‘This isn’t to say that we should all avoid full-strength soft drinks, but to keep on the healthy diet food-frequency scale, consumption ought to rank as “occasional”(or even “keep for a treat” if you’re trying to lose weight) and definitely not be everyday. If consumption figures are any indication, an increase in sugar-sweetened soft drinks and cordials is contributing to our child obesity problem. Not only have fatter children been found to have higher consumption, but overall, our children are drinking more of these sweetened drinks than we ever did when we were kids. And of course the increase in serving size from the old fashioned 8 oz (240 ml) to the current 600 ml ‘buddy’ doesn't help. It isn't only soft drinks and cordials that are the problem either. Too much fruit juice, sweetened or unsweetened, is an easy way for us to gulp down extra calories.’

Do You Have the GI for Fresh Rhubarb Stalks?No. Despite being popularised by celeb chefs as a great low GI food in their TV shows and books, fresh rhubarb contains so little carbohydrate (less than 2 grams per 100 grams), that it is actually not possible to measure its GI. But if you like to crunch raw rhubarb, pile your plate high and enjoy a veggie that’s a great source of vitamin C and potassium and a good source of fibre with virtually no calories and certainly no fat. However, most of us find eating rhubarb this way a little hard to take: unbearably tart and way too crunchy. And so we cook it and sweeten it. And that’s where the carbs come in along with the calories (kilojoules) – and the GI. Sugar is probably the favourite sweetener (brown sugar is hard to beat) and many recipes recommend around 120 g/4 oz sugar (or even more – they call it ‘to taste’) to 450 g/1 lb chopped rhubarb stems. However, you can sweeten rhubarb in other lower GI ways: try combining it fifty/fifty with chopped (low GI) apple, a little grated ginger root, the juice of 1 orange and about 3 tablespoons of pure floral honey … or leave out the ginger and orange and bake it with a couple of split vanilla beans. The options are endless as you’ll find if you check out the ‘Rhubarb Recipe Collection’ on www.rhubarbinfo.com/recipe-index.html

Rhubarb is a leafy vegetable from the buckwheat family (it’s a cousin of sorrel) but in 1947 the US Customs Court in Buffalo New York classified it as a fruit because that’s mostly how we eat it. The red stems are the edible bit; the leaves are toxic. When shopping, choose bunches with slender, younger stems that are dark pink to red. The thicker the stalk the stringier it gets. It is a very versatile veg (fruit). Just trim the ends, remove the leaves and cut the stems into 2.5 cm (1 inch) chunks. It cooks down to a syrupy liquid in minutes so don’t add too much water and watch the pot. You can also cook it in the microwave or bake it in the oven.

Freelance home economist and former dietitian Diane Temple created this colourful dish especially for GI News. It is quick to prepare, full of flavour, and an easy way to get some of the five serves of vegetables you need every day. Serve with a mixed lettuce salad dressed with olive oil and lemon juice. It’s all you’ll need. If you use fresh capsicum (pepper), add it to the pan with the onion and garlic. For professional recipe development or testing you can contact Diane on tel 612 9958 3165; email: diane.temple@bigpond.com

Preheat oven to 180ºC (350ºF). Steam or microwave sweet potato until cooked. Set aside to cool.

Meanwhile, in a large non-stick frying pan, heat the oil and cook onion, garlic and rosemary until soft, about 3–4 minutes. Add the tomatoes, bring to the boil and then reduce the heat and simmer for 5 minutes. Stir through the lentils, red peppers, parsley and peas. Season to taste with freshly ground black pepper and cook for 2 minutes or until the mixture is just heated through.

In a 1½ litre (6-cup) baking dish, spoon in half the lentil sauce, then layer with half the sweet potato and half the cheese. Add remaining lentil sauce, then the sweet potato. Sprinkle the remaining cheese over the top. Bake in the oven for 30–35 minutes or until cheese has melted and top is lightly golden.

Nutritional analysis per servingWe have included a nutritional analysis using standard pizza cheese and reduced fat pizza cheese. As you can see, there’s not a great deal of difference nutritionally in this recipe. So, if reduced fat pizza cheese is not on the supermarket shelf, use pizza cheese and you'll still be enjoying a reasonably low fat meal with lots of delicious veggies.

‘A low GI diet – best thing I've done in a long time’ says Lorraine‘I started hearing about low GI diets back in 2004 but only looked into them properly in early 2005. At the time I weighed 90 kg which was at least 20 kg over a healthy weight. Ironically, I work in the fresh produce industry, I had a good working knowledge of nutrition and healthy eating guidelines plus I have quite good cooking skills. Previous attempts at calorie-controlled diets failed because the hunger pangs would win out in the end. And a few months going low carb in search of a quick fix left me heavier than ever.

After reading up on GI principles and seeing that this clearly wasn’t another complicated fad diet I opted to join an excellent online site offering a personalised GI diet plan. Pretty quickly I could see that I hadn't been eating regularly enough, my food choices hadn’t been ideal, there hadn’t been enough variety in my diet and that my portion control had been non-existent.

Today I am 21 kg lighter and have a healthy BMI (body mass index). I maintain my weight by a combination of sensible portion control and food selection. Fruit, vegetables, salads and pulses are now the major part of my diet. Pasta/rice/bread and potatoes are limited to much smaller portions and are always the wholegrain version. I limit meat to two or three small portions per week (red meat just once a week) and I try to include a low-fat dairy item every day. I've found that the GI principles are flexible enough to be applied to eating out, holidays, special occasions and so forth. It’s a rare event when I'm faced with a choice where nothing is suitable. Not everything I eat is low GI by any means, but certainly the majority.

Medically speaking I feel much fitter. An asthmatic condition has all but disappeared and I am confident that I have halted what would have been an inevitable slide into diabetes, heart disease and a host of other more minor complaints.’

Jaws dropped at the gym when Margaret walked in‘I was 60 years old last July. When I saw the photos of me at my surprise birthday party I was depressed at the amount of fat that had accumulated around my midriff! I weighed 80 kg and should have weighed 65 kg. I set out to put this right by eating ‘diet’ and ‘low fat’ foods along with my regular gym sessions and lots of walking. I was attending my local gym on average five times weekly for aquarobics and Pilates. Nothing was working. Very frustrating and even more depressing! I attended a session at the local RSL Club at which Dr Sandra Cabot was speaking about the effects of high GI carbs and sugar in foods and their impact on the syndrome X condition. It just clicked with me that I was going down the wrong path to achieve weight loss. I weighed 82.7 kg that day.

By 24 January 2006, I weighed 76 kg and my doctor was impressed! My subsequent blood glucose, cholesterol tests were all in normal range. They were all raised to upper levels of normal range in the previous year. Exactly one year on from my 60th birthday I am 72 kg and my BMI = 26.4, a bit too high still. Waist is 84 cm and hip 111 cm. I am wearing size 14 much better than the 16–18s of last year! I feel great but know that a few less kilos would be preferable. My goal is 68 kg. However, I have so much more energy for all the activities of daily life including an upcoming trip to China, Northern Thailand and Nepal assured in the knowledge that I will have the energy to enjoy fully all that these countries have to offer. All the people who attend my gym classes have remarked on how great I look and want to know what the ‘secret’ is!’

Question: Why is it that over 80% of people who lose weight eventually regain what they lose and often more?Answer: Because dieting is not about what we eat, it is about why we eat. Diets typically fail to recognise that food is the world’s most addictive substance. Craving food is much more widespread than craving nicotine, alcohol and other substances.

‘It’s not what in your mouth, it’s what’s in your mind’ says George Blair-West. As Director of Psychophysiology at the Obesity Rehabilitation Unit at River City Private Hospital in Brisbane and a weight-loss group psychotherapist, his particular area of interest is helping people maintain long term weight loss. This isn’t another diet book. There’s not a food menu or recipe in sight. Weight Loss for Food Lovers talks about motivation and sabotage, and provides practical strategies to help people maximise their chances of success whatever diet they embark on. When talking about carbs, Blair-West opts for the glycemic load (GL) approach and includes a GL table of foods derived from The New Glucose Revolution (Brand-Miller, Foster-Powell and Colagiuri). But you need the serving size to put the good doctor’s advice into practice. Go to The New Glucose Revolution Shopper’s Guide 2006 or www.glycemicindex.com for GI, GL, carbs per serving and the serving size.

What’s the GI of meat, chicken, fish, eggs and cheese? I can’t find these foods in the GI database.The GI is a measure of carbohydrate quality. Meat, eggs, fish and cheese are protein foods so they don’t have a GI because they have either no carbs, or so little the GI can’t be measured.

Eaten alone protein foods like these have very little effect on your blood glucose levels. It’s carbohydrates that are mainly responsible for the rise and fall in blood glucose after meals. Foods that are high in carbs include:

Cereal grains (rice, wheat, oats, barley and rye and anything made from them like bread, breakfast cereals, pasta and noodles)

Starchy vegetables like potatoes, taro, yams, sweet corn and sweet potatoes. Most green or salad vegetables have so little carbohydrate we can’t measure the GI

Dairy foods like milk, ice cream and yoghurt (but not cheese which is a protein food, or butter or cream which are mostly fat)

I have heard that pasta made of strong wheat flour (such as durum) has a lower GI than pasta made of softer wheat flour. Is this true? We asked Prof. Jennie Brand-Miller to answer this. She says: ‘My understanding is that durum wheat is a very hard wheat and that makes it ideal for pasta manufacture. It gives the pasta its lovely golden colour because the aleurone layer is included with the endosperm fraction. Hardness and strength are two different things. Hardness refers to how the grain cracks up in the milling process, while strength refers to its protein content. Many Australian wheats, for example, are both hard and strong at the same time, making them highly desirable for many applications, especially bread making.’

She goes on to say, ‘I have seen data showing that pasta made from any old wheat has a relatively low GI. It's the low degree of gelatinisation (low moisture dough) that makes it low GI. The high protein content might help a little but it’s not the major factor. If you make bread from durum wheat, it will have a high GI because bread making allows for full gelatinisation. If you overcook pasta (perhaps canning too), then it will become more highly gelatinised and that will increase its GI. For the most part, properly cooked pasta (al dente) has a GI of 40–50.’

I've been following The Low GI Diet and have noticed some recipes include the use of filo pastry. Does filo pastry have a low GI? I love spinach pastries and even vegetable pies, but I am wondering if pastries have a high GI value? Pastry by itself hasn’t been GI tested. It’s not something you normally eat as a meal. But the real problem with most shortcrust and flaky pastry products is that they tend to be very high in fat, particularly saturated fat (remember the ingredients for making pastry are essentially flour and butter with a little water plus sugar for a sweet pastry). The reason we include occasional recipes with filo pastry is that you can get that lovely crisp in the mouth pastry feel with a lot less fatty pastry. Just 2 or 3 sheets of filo lightly sprayed with olive oil (not melted butter) will do the job. So a spinach triangle or a vegetable pie made with filo can provide a nourishing and tasty meal and help you achieve those five serves of veggies a day – providing you make sure it’s got lots of veggie filling and just a little filo pastry! Catherine Saxelby’s Fresh Plum and Ricotta Strudel made with a few sheets of filo shows you how you can up your fruit intake with a delicious low fat, low GI dessert. You’ll find the recipe in our January 2006 GI Newsletter.

Photo: Ian Hofstetter, The Low GI Diet Cookbook

I have read in some GI lists that fresh coconut is low GI, is this true? Coconut does not seem to be on your list!Coconut is a nut (not a fruit) and it has not been GI tested. It contains very little carbohydrate per serving (just 1 g in a 15 g portion) and it is virtually impossible to GI test. But it is high in fat (5 g in a 15 g portion) and the fat it contains is nearly 90 per cent saturated. So use very small amounts of coconut products such as coconut milk or desiccated coconut in your cooking.

Look it up in our A–Z: The GI Glossary continued

Atherosclerosis or hardening of the arteries is a slow progressive disease and can go virtually unnoticed until it produces problems such as angina or a heart attack. Most heart disease, whatever form it takes, is caused by atherosclerosis—clogging on the inside wall of the arteries through the slow build up of fatty deposits (called plaques) which narrows the arteries and reduces the blood flow. This is not just a ‘plumbing’ problem, but one in which inflammation plays a key role. Atherosclerosis can affect the arteries elsewhere in the body including the brain, kidneys, and the arms and legs. When the arteries to the heart are affected and blood flow is reduced, the heart muscle doesn’t get enough oxygen for pumping blood, and eventually this causes central chest pain (angina pectoris). Elsewhere in the body when blood flow is restricted by atherosclerosis there’s a similar effect: in the legs, it can cause muscle pains on exertion; in the brain, it can lead to a variety of problems from ‘funny turns’ to strokes. An even more serious consequence of is when a thrombosis (blood clot) forms over a patch of atherosclerosis on an artery. This process can occur anywhere in the arterial system and lead to a complete blockage of the artery. The consequences can range from a small heart attack to sudden death.

Beta cells The cells in the pancreas that produce insulin. They are found grouped together in the Islets of Langerhans.

Blood pressure The pressure of the blood on the walls of the blood vessels caused by the beating of the heart. Every body has blood pressure, although not everyone’s blood pressure is high. Hypertension is defined as having blood pressure above 140/90 mm HG. An abnormal blood pressure is considered to be 120/80.

Carbohydrate, a vital source of energy found in all plants, is the starchy part of foods like rice, bread, legumes, potatoes, and pasta and the sugars in foods like fruit, milk and honey. Cheap, plentiful and sustainable, it is the most widely consumed substance in the world after water and the basis for a healthy diet. Some foods contain a large amount of carbohydrate (such as cereals, potatoes, and legumes) while other foods such as carrots, broccoli and salad vegetables are very dilute sources. The simplest form of carbohydrate is glucose, which is a universal fuel for our body cells, the only fuel source for our brain, red blood cells and a growing foetus, and the main source of energy for our muscles during strenuous exercise.

Cholesterol is a soft, waxy substance found in the blood and in all the body's cells. It's an important part of a healthy body because it is part of the walls around all of our cells, and is a major component of many of the hormones our body’s produce. Most of the cholesterol in our body does not come from the foods we eat, but is in fact manufactured by the liver. High levels of cholesterol in the blood may lead to blocked arteries, heart attack and stroke. Cholesterol and other fats can't dissolve in the blood. They have to be transported to and from the cells by special carriers called lipoproteins. There are several kinds, but the most common ones are low-density lipoprotein (LDL) and high-density lipoprotein (HDL).

Coeliac disease is a condition where the lining of the small intestine is damaged due to an immune reaction from your own body to a small protein known as gluten. Gluten is found in certain grain foods like wheat, rye, triticale and barley, and in much smaller amounts in oats (as a contaminant). The only treatment for coeliac disease at present is a gluten-free diet.

DiabetesType 1 diabetes is characterised by high blood glucose levels due to the body’s complete inability to produce insulin. It occurs when the body’s immune system attacks the insulin-producing Beta cells in the pancreas and destroys them. The pancreas then produces very little or no insulin. Type 1 diabetes occurs most often in young people but can develop in adults.

Type 2 diabetes is characterised by high blood glucose levels caused by an insufficiency of insulin and the body’s inability to use insulin efficiently. It is thought to occur when the body becomes resistant to insulin. The pancreas compensates initially by producing more insulin, then eventually becomes exhausted and produces insufficient insulin. Type 2 diabetes occurs most often in middle-aged and older people but is being seen increasingly in younger adults and teenagers.

Gestational diabetes can occur during pregnancy, but usually goes away after the baby is born. Hormones released by the placenta during pregnancy reduce the effectiveness of the mother’s insulin. It is usually managed successfully with healthy eating and regular physical activity, but in some cases extra insulin is needed.

Dyslipidaemia abnormal levels or composition of the blood fats known as cholesterol and triglycerides.

Fat provides lots of kilojoules/calories – more than protein or carbs per gram – so you only need a small amount each day. The message today is know your fats. Focus on the good ones (mono- and poly-unsaturated fats) and give the bad fats (trans fats and saturated fats) the flick.Saturated fats are solid at room temperature. These are the fats on meat or chicken skin, and in butter, cheese, palm oil and coconut oil. We don’t actually need to eat any saturated fat, since the body can make all it requires, but it is fairly difficult not to eat some, since all fats are actually mixtures of saturated and unsaturated fats.Unsaturated fat is liquid at room temperature. These good mono- and polyunsaturated fats provide you with essential fatty acids that form your cell membranes; help you absorb the fat-soluble vitamins A, D, E and K; form part of your body’s hormones; provide insulation; and help you absorb some anti-oxidants from fruit and vegetables.Trans-fats are produced during manufacture and behave like saturated fat in a product (increasing its firmness), as well as in our bodies (increasing the risk of heart attack). Foods high in trans fats include fried fast foods, some margarines, crackers, cookies and snack – so read the label before you buy these foods.

Fatty liver is the build up of excessive amounts of triglycerides and other fats inside liver cells; also known as steatohepatitis or NASH (Non-Alcoholic Steato-Hepatitis).

Fibre Dietary fibre only comes from plant foods – the outer bran layers of grains (corn, oats, wheat and rice and in foods containing these grains), fruit and vegetables and nuts and legumes (dried beans, peas and lentils). We need about 30 grams of fibre a day for bowel health and to keep regular. There are two types of fibre—soluble and insoluble—and there is a difference.Soluble fibres are the gel, gum and often jelly-like components of apples, oats and legumes. By slowing down the time it takes for food to pass through the stomach and small intestine, soluble fibre can lower the glycemic response to a food. Good sources include: oatmeal, oat bran, nuts and seeds, legumes (beans, peas and lentils), apples, pears, strawberries and blueberries.Insoluble fibres are dry and bran-like and commonly called roughage. All cereal grains and products that retain the outer coat of the grain they are made from are sources of insoluble fibre, eg wholemeal bread and All-Bran®, but not all foods containing insoluble fibre are low GI. Insoluble fibres will only lower the GI of a food when they exist in their original, intact form, for example in whole grains of wheat. Here they act as a physical barrier, delaying access of digestive enzymes and water to the starch within the cereal grain. Good sources include: wholegrains, wholewheat breads, barley, couscous, brown rice, bulghur, wheat bran, seeds, and most vegetables.

Fructose or fruit sugar is an alternative sweetener that is nearly twice as sweet as table sugar but provides the same amount of kilojoules. As the name suggests, it is found naturally in most fruits.

Carbohydrates, Glycemic Index and Health: The State of the ArtMillions of people around the world are following carbohydrate-modified diets for weight loss as well as general health, judging from the sales figures for popular diet books including, Atkins’ New Diet Revolution, The Zone, The South Beach Diet, The Glucose Revolution, and at least two dozen other titles. With regard to low glycemic index diets, major studies have been published in JAMA, The Lancet, AJCN, American Journal of Epidemiology and International Journal of Obesity in the last three years suggesting beneficial effects on appetite, energy metabolism or body weight. Other recent studies have been inconsistent. How do we distinguish between the good and poor research in this field? What is the difference between low glycemic load and low glycemic index? How do approaches that aim to reduce carbohydrate amount compare with those that focus on carbohydrate quality, specifically GI? Are some individuals more likely to see benefits of low GI diets than others? Are these diets safe over the long term? This ‘state of the art’ one-day symposium in Sydney, Australia on 2 September 2006 will provide a forum for the vigorous exploration of these questions.

The sponsor: The University of Sydney Nutrition Research FoundationThe convenors: Prof Jennie Brand-Miller, Human Nutrition, The University of Sydney, Australia and Prof David Ludwig, Boston Children’s Hospital, USAFor more information Ms Elisabeth EatonGI Symposium Secretariat, PO Box 949, Kent Town SA 5071, Australiaphone +618 8363 1307; Fax +618 8363 1604email FI2006@fcconventions.com.auDietary Study for Women with PCOSThe University of Sydney is conducting a dietary study for women with PCOS. If you live in Sydney, Australia, are aged 18–40 with PCOS and are not taking the pill or trying to conceive, contact pcosdietstudy@nnd.com.au for more details.

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